Medical imaging often includes creating images and/or video sequences of the human body or parts of the human body for clinical purposes such as examination, diagnosis and/or treatment. These images may be acquired by a number of different imaging modalities including, for example, ultrasound (US), magnetic resonance (MR), positron emission tomography (PET), computed tomography (CT), mammography (MG), digital radiology (DR), computed radiology (CR) or the like. In a number of example medical imaging workflows, such as in the case of a picture archiving and communications system (PACS), a digital image data file for a patient may include one or more acquired images of the patient along with information that may reside with or otherwise accompany the images. This information may include, for example, a study identifier (ID) as well as patient information such as the patient's name, demographic information, medical record number or the like.
A PACS may permit the digital imaging data file to be viewed, such as for diagnostic purposes, and/or archived for subsequent viewing and/or processing. A PACS workstation may present images or series of related images on the display within a software construct called a viewport. While viewing a medical image, a healthcare provider may wish to manipulate, e.g., modify, the image within a viewport to better view a portion of the image or to adjust the image for better visualization of the pixels. Examples of image manipulation include a window and level adjustment operation, a panning operation, and a zoom operation. A healthcare provider may also wish to navigate a series of related images within a viewport, typically involving a scroll operation. Typically, a healthcare provider who is viewing medical images on a PACS workstation utilizes a mouse in order to provide input regarding manipulation of the image, or navigation of images within a viewport. A conventional mouse includes left and right mouse buttons so as to allow the user to provide discrete input such as a selection, or command. A conventional mouse also incorporates a wheel, generally positioned between the left and right buttons, that can be rotated either forwardly or rearwardly to provide further input such as varying a single parameter through a range. A mouse also provides simultaneous two parameter input by movement forward and back or left to right on a support surface. In this regard, the position of the cursor on the display may be controlled by movement of the mouse. An image may be selected and moved from or to a viewport by actuating the left mouse button and moving the mouse followed by release of the left mouse button at the desired target display location. Thereafter, the right mouse button may be actuated to indicate that the medical image is to be manipulated. Further input regarding image or viewport manipulation that is to be performed may be provided by rotating the wheel in either of the two opposed directions or by moving the mouse while continuing to depress the right mouse button.
Because of the number of different types of image manipulation operations, a mouse may be unable to provide a sufficient number of distinct inputs in order to individually select each of the different image manipulation operations and to then provide the input necessary to effect a selected image manipulation operation. By way of example, the window and level adjustment operation and the panning operation each require input to simultaneously adjust two variables. In this regard, a mouse may be positioned such that the cursor overlies a particular medical image that has already been zoomed such that its magnification makes it larger than the bounds of the containing viewport. By actuating the left mouse button and then moving the mouse while continuing to actuate the left mouse button, the image may be panned by being dragged in the X and Y directions within the viewport in which it is currently displayed, showing portions of the image not currently visible. However, the actuation of the right mouse button and the subsequent movement of the mouse while the right mouse button remains actuated may cause a window and level adjustment operation to be implemented. In this regard, the window and level adjustment operation allows two parameters to be controlled based upon the movement of the mouse in the X and Y directions while the right mouse button remains actuated.
As noted above, three operations, e.g., selecting and moving an image into or out of the viewport, panning the image within the viewport, performing a window and level adjustment operation, requiring selection with a mouse button and simultaneous X and Y motion of the mouse have been described, and only two mouse buttons are available, the left and right buttons. In this example the select and move an image to or from a viewport operation, and the pan image within a viewport operation both require the left mouse button to select the operation. The panning operation may not typically be performed based upon input provided only by the mouse. Instead, a healthcare provider who is viewing the image and desires to pan the image may be required to initially depress a predefined keyboard shortcut modifier key, such as the shift key, in order to activate the panning operation and to distinguish subsequent mouse input from comparable mouse input provided in conjunction with the operation relating to selecting and moving an image into and out of a viewport. Once the keyboard shortcut modifier key has been actuated, the healthcare practitioner may select to pan the medical image by actuating the left mouse button while the cursor overlies the image and then moving the mouse while the left mouse button remains actuated in order to perform the panning operation. The use of a keyboard shortcut modifier key makes the performance of a panning operation more complex and may be particularly challenging in instances in which the healthcare practitioner is not only manipulating an image displayed by a PACS workstation, but concurrently operating a speech microphone in order to dictate a report that describes or references the medical image. Indeed, the healthcare practitioner may have to set down the speech microphone in order to pan the medical image which may, in turn, decrease the efficiency with which the healthcare practitioner completes the report. Alternatively, the healthcare practitioner may have to perform an awkward movement in an effort to both depress the keyboard shortcut modifier key while still holding the speech microphone.
Other types of image manipulation operations require adjustment of a single variable. For example, a scroll operation and a zoom operation each require change of a single variable over a range. In one example, an image viewport may be selected by hovering the mouse cursor over the viewport or by left clicking on the viewport and the series of images stacked for display in the viewport may be scrolled through the viewport by rotating the mouse wheel in a respective direction, while the mouse cursor remains over the viewport. As described above in conjunction with the panning operation, the limited number of inputs that may be provided by a mouse may be unable to provide the control inputs for a zoom operation. Instead, in order to zoom, a healthcare practitioner may be required to actuate a keyboard shortcut modifier key, such as the control key, in order to actuate the zoom mode. The image displayed in the viewport being manipulated may then be zoomed to higher or lower magnification by rotating the mouse wheel in a respective direction, while the mouse cursor remains over the viewport. As described above, the actuation of the keyboard modifier key not only makes the image manipulation process more complex, but may be difficult to perform in instances in which the healthcare practitioner is also holding a speech microphone.
As an alternative to the use of keyboard shortcut modifier keys, radio buttons may be presented upon the display, such as within a dialog box or window, in order to permit the healthcare practitioner viewing the medical image to switch from a mode in which the scroll and move image to or from a viewport operations are performed in response to the actuation of the wheel and the left mouse button respectively to a mode in which the zoom and panning operations are performed in response to the actuation of the wheel and the left mouse button respectively by selecting the appropriate radio button. However, such a zoom and pan tool also complicates the image manipulation process by requiring additional and different kinds of user input. Additionally, a zoom and pan tool cannot generally permit an image to be both zoomed and panned without requiring selection of a zoom mode or a pan mode in the graphical user interface, which takes additional time. Another alternative approach to providing the full set of required functions from one hand operating the computer mouse could be to use a computer mouse with additional buttons beyond the standard left and right buttons mapped to the respective command modes. However, the use of a computer mouse having additional buttons disadvantageously requires more complex hardware and more complex and less ergonomic user interaction.